Bone and Mineral Homeostasis Flashcards
What are the signs and symptoms of excess PTH?
Painful bones
Renal Stones
Abdominal groans
Psychic overtones
What is the action of PTH on the kidneys?
Decreased CA excretion
Increased PO4 excretion
What is the effect of Active Vit D metabolites on the kidneys?
Increase calcium and phosphate resorption
TRUE OR FALSE
High doses of PTH will lead to increase bone resorption, hypercalcemia and hyperphosphatemia.
TRUE
High doses of PTH will lead to increase bone resorption, hypercalcemia and hyperphosphatemia.
Low intermittent doses of PTH will lead to a net increase in bone formation.
RECOMBINANT PTH HORMONE
TERIPARATIDE
TRUE OR FALSE
Osteoclast activation is a direct effect of PTH.
FALSE
Osteoclast activation is an indirect effect from the promotion of bone turnover through PTH stimulation of osteoblast formation of RANKL.
INACTIVE VITAMIN D
Cholecalciferol
Ergocalciferol
ACTIVE VITAMIN D
Calcitriol
Doxercalciferol
Paricalcitol
Calcipotriene
Used for treatment of Paget’s Disease of the Bone
Calcitonin
Non Hormonal Regulators of Bone and Mineral Homeostasis
Biphosphonates Phosphate Binding Resin SERM Anti-RANKL Monoclonal Ab Cinacalcet Calcium
MOA: BIPHOSPHONATES
-dronates, zoledronic acid
inhibits bone resorption
suppresses osteoclast activity by inhibiting farnesyl pyrophosphate synthesis
acts on basic hydroxyapatite structure
AE of BIPHOSPHONATES
Adynamic Bone
Esophagitis
Osteonecrosis of the Jaw
Renal impairment GI irritation
Biphosphonates should be taken with ?
WATER
take lots of water with patient in upright position for 30mins after drug intake
Biphosphonates are contraindicated in
renal impairment, esophageal motility disorders and peptic ulcers
PHOSPHATE BINDING RESIN
SEVELAMER
